Papulo-purpuric dermatitis of childhood: a distinct PLEVA-like eruption associated to SARS-CoV-2 infection. Clinical, histopathological and immunohistochemical study of 10 cases

Raffaele Gianotti; Lucia Restano; Mario Cutrone; Cristiana Colonna; Giovanni Fellegara; Isacco Debernardi; Francesca Boggio; Alessandro Del Gobbo; Nicola Adriano Monzani; Claudio Tripodo; Carlo Gelmetti; Emilio Berti

doi:10.1111/pde.14777

Papulo-purpuric dermatitis of childhood: a distinct PLEVA-like eruption associated to SARS-CoV-2 infection. Clinical, histopathological and immunohistochemical study of 10 cases

Pediatr Dermatol. 2021 Sep;38(5):1185-1190. doi: 10.1111/pde.14777. Epub 2021 Aug 31.

Affiliations

¹ Department of Pathophysiology and Transplantation, Dermatology Unit, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
² Department of Clinical Sciences and Community Health, Pediatric Dermatology Unit, Foundation IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
³ Dipartimento Materno Infantile Unità Operativa di Pediatria e Patologia Neonatale, Vicenza, Italy.
⁴ Pathology Unit C.D.I. Centro Diagnostico Italiano S.p.A. Milan, Milan, Italy.
⁵ Division of Pathology, Università degli Studi di Milano, Foundation IRCCS, Cà Granda Ospedale Maggiore Policlinico, Milan, Italy.
⁶ Department of Clinical Sciences and Community Health, Neonatal Intensive Care Unit, IRCCS Foundation Cà Granda, Ospedale Maggiore Policlinico, Università degli Studi di Milano, Milan, Italy.
⁷ Tumor Immunology Unit. Department of Health Sciences, Istituto di Patologia Generale, University of Palermo School of Medicine, Palermo, Italy.

Abstract

We observed ten children with a papular eruption with purpuric features during the SARS-CoV-2 pandemic in Northern Italy (May-December 2020). Histological examination showed signs of SARS-CoV-2-related dermatosis. Evidence of nucleocapsid viral proteins using SARS-CoV-2 (2019-nCoV) nucleocapsid antibody revealed cuticular staining of the deep portion of the eccrine glands in all cases.

Keywords: PLEVA; SARS-CoV-2; dermatopathology; pediatric; skin histopathology.

MeSH terms

COVID-19*
Dermatitis*
Humans
Pandemics
Purpura* / etiology
SARS-CoV-2